Many people suffer from disturbed sleep.
When a patient tells me that they fall asleep easily, stay asleep through the night and wake up refreshed I feel like jumping for joy. Those with insomnia either have a hard time falling asleep, a hard time staying asleep, waking too early, or not feeling refreshed upon waking.
The solutions to each of these problems are multi-faceted.
Improve your sleep hygiene
My approach to any problem medical or otherwise is to first pick the low hanging fruit. In the case of a good nights rest, this happens to be sleep hygiene. Sleep hygiene is defined as all the behavioral and environmental factors that precede sleep or may interfere with sleep (Wikipedia). Below are my general rules for sleep hygiene followed by all the scientific gobbledygook.
- Turn off all screens 2 hours before bed (Yes, I know I can hear a collective “Yikes!”)
- Download Flux for your computer. This is especially important if you’re a late night computer addict. It will automatically adjust the color spectrum on the screen of your computer from blue light to red light which will have less of a negative effect on melatonin production.
- Dim all the lights in your home 1 hour before bedtime. Even better is to turn off all the lights and light a few candles.
- Do a simple relaxation ritual before you climb into bed. This can literally be 30 seconds of relaxation or prayer but it serves as a powerful reminder to your body that it is time to relax. I recommend 2-3 minutes of soft belly diaphragmatic breathing.
- Make sure your bedroom is completely free of light pollution. This means you should have good quality blinds to block out ambient light.
- Your bed is for sleep, sex, and maybe a little softcore wrestling with your significant other or your kids, but not for work. Keep it that way.
- The experts say go to sleep and wake up at the same time every day. I admit my city life seems to get in the way of this rule but we should all try our best to have a regular sleep schedule.
- If you get up at night to pee try to not turn on any lights. Or if you can’t see then get a red (see below for why) nightlight because I don’t want you to sue me for stubbed toes. Your pineal gland won’t get fooled by the red part of the color spectrum.
- Exercise. Watch a little kid run around all day and then knock out at soon as he/she gets home. If you have somehow convinced yourself that you have no time to fit in exercise then at least stand up at work.
- Visit an acupuncturist. I know it’s a shameless self plug but I wouldn’t say it unless I knew it helped. Plus there are a bunch of studies that confirm my own conclusion (Cao).
Cortisol, Melatonin and the Science of Sleep
Cortisol is a hormone secreted by the adrenal glands that serves many important purposes in the body. Too little cortisol and you will be depressed. Too much and you’ll be completely stressed out.
Cortisol in our bodies runs in a diurnal (24 hour) cycle. It rises in the morning and is one of the main things that gets us out of bed. It falls throughout the day and should be at it’s lowest at night. Low cortisol levels along with production of melatonin by the pineal gland makes us tired and we fall asleep. Higher cortisol levels can decrease melatonin production leading to difficult sleep.
To the right is a graphic of my own cortisol levels from a year or so ago when I was faced with my own insomnia issues. Notice that Cortisol levels start high, fall throughout the day then “pop” up at night. I was having a ridiculous time falling asleep and would wake up periodically throughout the night. With the help of herbs, acupuncture and proper sleep hygiene I corrected the problem, but it wasn’t easy.
Why Light is the Enemy of Sleep
The pineal gland is a light sensitive gland in the middle of the brain that begins to secrete melatonin in the absence of light. Watching TV, working in front of your computer or even playing on your phone in the two hours before bed will decrease the amount of melatonin secreted from the pineal gland and it will be more difficult to fall asleep.
The pineal gland is especially sensitive to the blue light spectrum, which is the exact spectrum that is created by screens and compact fluorescent lightbulbs. Ironically incandescent light bulbs emit a red spectrum light that is far less disturbing to the pineal gland. Heck, maybe Michelle Bachmann was just trying to promote restful sleep when she wanted to preserve consumer’s freedom of choice to buy lighting products. Politics notwithstanding, this is why it is important to turn down the lights in your house an hour before bedtime.
Also make sure that there is no light pollution in your bedroom. Even small amounts of ambient light can disturb the delicate balance of sleep. Nightlights, electronics, and light from the street are all potential problems. Turn all your electronics off and make sure that your blinds block light coming from the outside. Any lights you turn on at night should be red spectrum lights. Put a red light in a lamp in your bedroom in case you need to get up to use the bathroom at night.
Create a Pre Sleep Ritual
We often disregard the importance of ritual in todays teched out world. A pre-sleep ritual will not only remind our conscious mind that it is time to hit the hay but also our unconscious mind. It may seem like it is our conscious mind keeping us awake with the thoughts running through our head at a million miles per hour but it is our subconscious that makes those thoughts go.
When we do a few minutes of soft belly breathing, meditation, or journaling before bed we clear out many of those pesky thoughts and feeling that may have been unresolved by the days activities. Many people notice that when they do a conscious relaxation technique prior to bed they fall asleep much more quickly.
Your Bed is Not Your Office
Don’t do any work in your bed. Sleep in your bed, have lots of sex in your bed (or anywhere else for that matter), and read. If you do read, don’t read non-fiction. It will stimulate your mind and keep you thinking. Again, the body likes habits. Don’t give an excuse to not use your bed for sleep.
Tire Yourself Out
Make sure that you are actually tired at the end of the day. I’m not talking about fatigue and brain fog induced tiredness that produces cravings for sugar, caffeine and alcohol. I’m talking about actual physical exhaustion. Exercising in whatever form will help significantly.
Seth Roberts has done a whole lot of self tracking and writes about some interesting results of one legged and two legged standing and it’s effect on sleep quality. He recommends standing on one leg until muscle failure ensues in order to sleep better.
If you are a construction worker or professional athlete you don’t have much to worry about in this regard. But if you sit at a desk then start exercising regularly or stand up at your desk all day.
Take Care of Yourself
Finally if you follow all of the appropriate hygiene suggestions and you still are not getting quality sleep it’s possible you are having hormone disregulation issues. Visiting an acupuncturist, naturopath, or an MD who practices integrative medicine and has a good working knowledge of hormones can help you get back to sleep with less frustration.
- Journal of Alternative and Complementary Medicine. 2009 Nov. Acupuncture for Treatment of Insomnia: A systematic review of randomized controlled trials. Cao H, Pan X, Li H, Liu J.